Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Getting all of the vaccinations that you had before your autologous stem cell transplant is a component of the standard-of-care therapy plan for all newly diagnosed multiple myeloma patients.
Unfortunately, many MM survivors are conflicted about getting the many vaccinations that they got over a lifetime. More importantly, the possible side effects of vaccinations are in the public’s mind these days.
The question below is a common one I receive from MM survivors who have recently completed an autologous stem cells transplant. The studies linked and excerpted below my exchange with Miquel document oncologies thinking.
David Emerson
Hi David- I was diagnosed with MM exactly a year ago. (I’m currently 70 yrs old.} At the time 95% MM cells were found in my bone marrow. I never had any bone lesions or bone pain…every PET scan was normal.
The oncologist/hematologist started me on
In 3 months my bone marrow biopsy results were down to less than 5%. The doctor was amazed at the response. I stayed on the chemo regimen until I underwent a ASCT at Mayo in January. In April a follow up biopsy at Mayo showed .0003…( 3 suspect cells in a million) which is considered close to MRD (minimal residual disease).
I am currently receiving maintenance chemo (10mg Revlimid 2 weeks a month and a Velcade injection twice a month). I feel I am back to 100%… feel really good. My blood work twice a month shows all pretty much back to normal.
Now the decision I’m facing is the recommendation that I get all my childhood vaccinations over again which I am not comfortable with. I have never had a Covid vaccination and will never take it… and I’m not a believer in the efficacy of flu shots either.
My oncologist at Mayo strongly recommended all the vaccinations as did my oncologist here at home. They say my immune system is still somewhat compromised. Any recommendations would be appreciated. Miguel
Vaccinations are central to medical care. How do they affect cancer patients?
“INTRODUCTION- Prevention of infection is of paramount importance to the ever-increasing population of patients who have impaired immunity, such as those who have undergone hematopoietic cell transplantation (HCT).
Infection in these patients often results in excessive morbidity and mortality, and antimicrobial therapy is typically less effective than in the immunocompetent host [1]. Although immunization appears to be an obvious way to prevent infection, many patients with impaired immunity are unable to mount a protective immune response to active vaccination.
Furthermore, immunization with live virus vaccines may result in unchecked proliferation of attenuated strains.
Other issues related to infections in HCT recipients are reviewed separately. (See “Evaluation for infection before hematopoietic cell transplantation” and “Overview of infections following hematopoietic cell transplantation” and “Prevention of infections in hematopoietic cell transplant recipients” and “Prevention of viral infections in hematopoietic cell transplant recipients” and “Prophylaxis of invasive fungal infections in adult hematopoietic cell transplant recipients”and “Prophylaxis of infection during chemotherapy-induced neutropenia in high-risk adults”.)
RISK OF INFECTION- The risk of acquiring infection and the inability to prevent infection by immunization are directly related to the patient’s “net state of immunosuppression” or severity of disease. The greater the degree of immunosuppression, the less likely the patient is to respond to immunization. Although certain vaccines provide some benefit to the immunocompromised patient, an adequate response cannot be assumed.
Successful protection of the immunocompromised adult may require the use of vaccines and/or passive immunization (ie, immune globulin) as well as adjunctive measures, such as antiviral drug prophylaxis during influenza A outbreaks. (See “Seasonal influenza in adults: Role of antiviral prophylaxis for prevention” and “Seasonal influenza in children: Prevention with antiviral drugs”.)
“…Patients after autologous, and specifically after allogeneic transplantation have severely reduced antibody titers, and therefore require a broader spectrum of vaccinations. Response to vaccination in myeloma often is less vigorous than in the general population, mandating either measurement of the postvaccination antibody titers and/or repeating the vaccination. Here, we compile the existing data on vaccination in multiple myeloma and provide recommendations for clinical practice…”